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Diet Drug Review: Dangers and Side Effects

Diet Drugs Were Never A Good Idea Anyway, Say Pros

--by Susan Henry

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That giant exhaling sound you hear is a sigh of relief.

A substantial portion of physicians and nutrition and fitness professionals never thought "diet drugs" were a good idea, anyway; and, they say, now that the major ones -- Redux, Pondimin, the fen-phen family -- have been withdrawn from the market, people can go about losing (or maintaining) weight the way they should have been doing all along.

What way is that? In the words of Independence, Oregon physician William Brust's prescription to overweight patients: "Don't eat so damn much!" (One of his patients calls him Dr. Brusque.) He adds, "Eat as if you don't exercise and exercise as if you eat a lot."

Even as far back as the early eighties, Dr. Brust and his partner, Dr. Paul Young, refused to "prescribe pills" for losing weight. First off, said Dr. Young, "We think those pills are more a placebo than anything. It's mind over matter: people having faith in pills are so sure they're going to work, they make them work -- by dieting and exercising." Secondly, he said, "People stop taking a pill and they put the weight back on. They start relying on something artificial and ignore the health principles." And in a thirteen-year-ago prophecy which has now been fulfilled, Brust and Young said, "we don't know what the long-term side effects [of diet drugs] might be."

On September 14, the Associated Press reported that Dr. Sheldon Levine, author of The Redux Revolution, regretfully noted not knowing the long-term effects of the weight-loss drug he promoted. Dr. Levine has taken his books off the bookstore shelves.

Talk radio doctor Dean Edell says, "A lot of doctors don't think you need a prescription and don't like to prescribe [medication] for every little thing, [but they] give patients a prescription anyway." Why? Edell says, "Because patients demand it. People go to a doctor with a complaint, and if they walk out with a prescription, they're happy." Some time ago, an article in Consumer Reports noted the same thing, and ABC News medical correspondent Dr. Timothy Johnson has often confirmed it.

A registered nurse-practitioner in the Portland, Oregon area told radio host Lars Larson (KXL, September 15, 1997) he was relieved the diet drugs are off the market. "Taking drugs to lose weight was never a good idea," he said. "Now we have an opportunity to teach real nutrition and real lifestyle changes." He, too, reported that most Pondimin-Redux-fen-phen prescriptions were written to placate patients. Diet drugs were never intended for people who needed to shed only a few pounds, he said; and in that sense, there was a lot of abuse in prescribing them. The drugs were also in great demand by people who saw them as a passive, no-effort way to lose weight, who thought that if they took a pill they'd automatically drop a lot of pounds.

"The medications have never been by themselves a way of simply and permanently losing weight. They have limited benefit," said FDA Acting Commissioner Dr. Michael Friedman.

What Are People Going To Do Now?

While many journalists are giving the topic a "What are people going to do? What are doctors going to prescribe?" spin, the medical community isn't lamenting the drugs' removal. Now people are left with a healthy, common-sense alternative, notes Dr. John Foreyt of Baylor College of Medicine. "The alternatives are to eat sensibly and exercise regularly."

Responding to the withdrawl of Redux and Pondimin, a physician at Oregon Health Sciences University told radio station KXL that OHSU never advocated drugs for non-morbid obesity. What OHSU physicians did advocate, he said, were changes in total lifestyle and plain-old self-discipline: a diet low in fat and high in fiber, fruits, vegetables, and grains, regular exercise, and plenty of water.

The nurse-practitioner reported on a weight-loss study conducted with OHSU. Subjects were twenty to fifty pounds overweight. One group took weight-loss drugs, no exercise and no dietary changes. The second group combined diet and exercise, but took no drugs. The third group was put on an exercise program only, no change in diet and no drugs.

The group which lost the most weight, and the only group that hadn't regained it a year later, was the exercise-only group. The nurse told Lars Larson, "My conclusion is that getting active is a permanent life change."

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